癌症病人疼痛、情緒困擾及睡眠情形之探討

A Study of Cancaer Patients' Pain, Emotional and Sleep Disturbance

癌症近十年來均居國人十大死因之首位，癌症病人的疼痛經常使病人陷於絕望、不安、焦慮、憂鬱、憤怒、疲倦或睡眠剝削狀態，進而影響生活品質。本研究目的係探討首次接受放射線治療之癌症病人，其疼痛、焦慮、憂鬱、睡眠之情形與相關因素。研究設計為相關性調查研究。受試者為某醫學中心放射線治療門診的病人，共收案70人。研究工具包括疼痛視覺類比量表、簡式麥基爾疼痛量表、情境-特質焦慮量表、貝克憂鬱量表、減壓狀態量表、與維式-辛式睡眠量表等6種量表。資料分析採描述性統計法、Fisher's exact檢定、平均數均差異考驗、單因子變異數分析、皮爾森相關係數、及無母數分析等。研究結果如下：本研究中首次接受放射線治療病人的疾病診斷以鼻咽癌最多。其次為前列腺癌、乳癌、肺癌、及子宮頸癌等；癌症病人於接受放射線治療初期，有52.8%的病人會痛，但其疼痛強度屬輕度，乳癌、肺癌病人感覺疼痛程度較強；癌症病人之情境焦慮呈中度或重度，然鼻咽癌與乳癌病人之情緒焦慮高於其他診斷病人，50歲以內人之情境焦慮則高於50歲（含）以上病人；癌症病人之憂鬱程度屬輕度，但肺癌病人憂鬱程度偏高；病人於收案當時之減壓狀態及睡眠情況尚好，不同診斷間不具差異；病人疼痛與特質焦慮、憂鬱程度互有相關，而情境焦慮、憂鬱此情緒困擾也與減壓狀態及睡眠情況互有相關。此結果可為處理癌症病人情緒困境之重要參考。

Cancer is the leading cause of death in Taiwan. Cancer patients often suffer from severe pain that limites the quality of life through provoking feelings of helpless, uneasiness, anxiety, depression, anger, fatigue, and sleep disturbance. The purpose of this study was to explore patients' pain, anxiety, depression, and sleep disturbance affer their first course of radiotherapy and related factors. The study was designed as a correlational study with seventy subjects from a medical center in Taiwan. This study used instruments, such as the VAS pain scale, the short form McGill Pain Questionnaire, the State-Trait Anxiety Inventory, the Beck Depression Scale, the RW Questionnaire, and VSH Sleep Scale Data analysis was conducted using Descriptive analysis, Fisher's exact test, t-test, one-way ANOVA, Pearson's correlation coefficient, and non-parametric test. The findings were as follows: Patients who were sampled in this study had nasopharyngeal carcinoma (NPC), prostate cancer, breast cancer, lung cancer, and uterine cervix cancer in sequence. Duing the first course of radiotherapy, fifty two percent of the patients had suffered from mild pain, but breast cancer and lung cancer patients suffered from a more severe pain. The anxiety level was either moderate or severe for all subjects. Patients with NPC had the most severe anxiety level compared to others. Patients under fifty years of age had more anxiety problems than patients with an age of fifty on older. The depression level for all subjects were mild, except for lung cancer patients who had suffered form moderate depression. The relax state and sleep situation of the patients proued fair with no difference ofter diagnosis. Pain in cancer patients was related to trait anxiety and depression. State anxiety and depression were related to relation and sleeing situation. These important findings could be a reference for further interventions for cancer patients.